Revised July 25, 2024:
Due to recent legal challenges concerning the 2025 Medicare Final Rule, the Centers for Medicare & Medicaid Services (CMS) released updated figures for Medicare Advantage and Part D broker commissions on July 18, 2024. These new figures override those published in the original memo from June 28, 2024, regarding Contract Year 2025 Agent and Broker Compensation Rates, Submissions, and Training and Testing Requirements.
2025 Medicare Broker Commissions Overview
Broker commissions are set to increase for the tenth year in a row. However, the 2025 increase will not include a fixed administrative fee. Moreover, CMS will reinstate the regulatory framework [42 C.F.R. 422.2274(e)], allowing for “Payments other than compensation (administrative payments).” This permits payments for services other than enrollment, such as training, customer service, agent recruitment, operational overhead, and assistance with health risk assessments, until the lawsuits are resolved.
For 2025, carriers will pay Medicare commissions similarly to previous years, adhering to the maximum amounts set by CMS. However, commission rates may differ between carriers and plans.
Medicare PDP Commissions
For 2025, agents will see an increase in FMV for PDP commissions:
- Initial Commissions: Rising from $100/member/year to $109/member/year, marking a 9% increase year-over-year.
- Renewal Commissions: Increasing from $50/member/year to $55/member/year, reflecting a 10% increase year-over-year.
Medicare Advantage Commissions
The 2025 FMV for Medicare Advantage commissions will also see an increase:
California and New Jersey:
- Initial commissions will rise from $762/member/year to $780/member/year, a 2.36% increase.
- Renewal commissions will go from $381/member/year to $390/member/year, a 2.36% increase.
Connecticut, Pennsylvania, and Washington D.C.:
- Initial commissions will increase from $689/member/year to $705/member/year, a 2.32% rise.
- Renewal commissions will go from $345/member/year to $353/member/year, a 2.32% increase.
Puerto Rico and the U.S. Virgin Islands:
- Initial commissions will rise from $418/member/year to $428/member/year, a 2.39% increase.
- Renewal commissions will increase from $209/member/year to $214/member/year, a 2.39% rise.
All Other States:
- Initial commissions will go from $611/member/year to $626/member/year, a 2.45% increase.
- Renewal commissions will increase from $306/member/year to $313/member/year, a 2.29% rise.
| Initial | Renewal | ||||||
| Product | Region | 2024 | 2025 | % | 2024 | 2025 | % |
| MAPD | National | $611 | $626 | 2.45% | $306 | $313 | 2.29% |
| CT, DC, PA, | $689 | $705 | 2.32% | $345 | $353 | 2.32% | |
| CA, NJ | $762 | $780 | 2.36% | $381 | $390 | 2.36% | |
| Puerto Rico, U.S. Virgin Islands | $418 | $428 | 2.39% | $209 | $214 | 2.39% | |
| PDP | National | $100 | $109 | 9% | $50 | $55 | 10% |
The industry is closely monitoring these developments and anticipates further details from CMS regarding these changes.
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If you have any questions or need further clarification on these Medicare commission changes, please don’t hesitate to reach out to our FMO at 919-460-6073 or [email protected]. We are here to help you navigate these updates and ensure you have all the information you need to succeed!
